Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo, Japan; Department of Epidemiology, St. Luke's International University Graduate School of Public Health, Tokyo, Japan; Fujita Health University, Toyoake, Japan.
Ohta Nishinouchi Hospital, Koriyama, Japan.
Complement Ther Med. 2019 Aug;45:33-37. doi: 10.1016/j.ctim.2019.05.019. Epub 2019 May 16.
Although Shiatsu, a kind of complementary alternative medicine, was developed in Japan and is practiced around the world, no experimental studies on Shiatsu have been conducted. The aim of this study is to investigate the efficacy of Shiatsu therapy for chronic lower back pain.
We conducted a prospective, randomized, open, blinded-endpoint design study at St. Luke's International Hospital, Tokyo, Japan from 2015 to 2017. Patients with lower back pain for more than 12 weeks and a score of four or more on the Roland-Morris Disability Questionnaire (RMDQ) at baseline were included in this study. We excluded patients with severe conditions, such as bone metastasis, or dementia. Patients were randomly allocated to either Shiatsu therapy in addition to standard care or standard care only by computer randomization. Those allocated to Shiatsu received one-hour Shiatsu every week for four weeks. Our primary outcome was improvement of RMDQ, and secondary outcomes were improvement of Short-Form McGill Pain Questionnaire (SF-MPQ), Oswestry Disability Index (ODI) and EQ-5D after 4 weeks and 8 weeks. Bivariate analyses were applied for assessing statistical significance.
Fifty-nine patients were included; 30 were allocated to Shiatsu, and 29 to the control group. None of the baseline characteristics were significantly different between groups. Twenty seven patients (90%) in the Shiatsu group and 24 patients (83%) in the control group completed the study. At week 4, Shiatsu group tended to show greater improvement only in EQ-5D (difference 0.068, p = 0.07), but not statistically significant, compared to control group, wheres other outcome measures were similar between the groups. At week 8, those in the Shiatsu group tended to have greater improvement in RMDQ (difference 1.7, p = 0.08) compared to the control group. The Shiatsu group showed greater improvement in present pain scale of SF-MPQ (difference 0.5, p < 0.05), ODI (difference 4.0, p < 0.01) and EQ-5D (difference 0.099, p = 0.01) compared to control group.
In our limited sample trail, Shiatsu therapy combined with standard care for lower back pain improves some symptoms and QOL shortly after Shiatsu therapy.
尽管指压疗法是一种补充替代医学，在日本发展并在世界各地应用，但尚未有关于指压疗法的实验研究。本研究旨在探究指压疗法治疗慢性下腰痛的疗效。
我们在日本东京圣卢克国际医院进行了一项前瞻性、随机、开放、盲终点设计的研究，纳入了腰痛超过 12 周且 Roland-Morris 残疾问卷（RMDQ）基线评分为 4 分或以上的患者。我们排除了严重的情况，如骨转移或痴呆。患者通过计算机随机分配至接受指压疗法联合标准护理或仅接受标准护理。接受指压疗法的患者每周接受 1 小时的指压治疗，共 4 周。我们的主要结局是 RMDQ 改善，次要结局是 4 周和 8 周后 Short-Form McGill 疼痛问卷（SF-MPQ）、Oswestry 残疾指数（ODI）和 EQ-5D 改善。我们采用双变量分析评估统计学意义。
共纳入 59 例患者，其中 30 例分配至指压组，29 例分配至对照组。两组患者的基线特征均无显著差异。指压组 27 例（90%）和对照组 24 例（83%）患者完成了研究。在第 4 周，与对照组相比，指压组在 EQ-5D 方面的改善趋势更大（差值 0.068，p=0.07），但无统计学意义，而其他结局指标在两组间相似。在第 8 周，指压组在 RMDQ 方面的改善趋势大于对照组（差值 1.7，p=0.08）。与对照组相比，指压组在 SF-MPQ 的现时疼痛评分（差值 0.5，p<0.05）、ODI（差值 4.0，p<0.01）和 EQ-5D（差值 0.099，p=0.01）方面的改善更大。
在我们有限的样本试验中，指压疗法联合标准护理治疗腰痛在指压治疗后不久可改善部分症状和生活质量。
